Provider Demographics
NPI:1205372836
Name:ERLACHER, AMBER MARIE (MPT)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:ERLACHER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 53RD AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7565
Mailing Address - Country:US
Mailing Address - Phone:635-322-0971
Mailing Address - Fax:
Practice Address - Street 1:510 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-6133
Practice Address - Country:US
Practice Address - Phone:309-797-0866
Practice Address - Fax:309-581-1500
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist